BK virus nephropathy in non-renal solid organ transplant recipients: Are we looking hard enough?

Ravi K. Mallavarapu, Scott L. Sanoff, David N. Howell, John K. Roberts

Research output: Contribution to journalArticlepeer-review

Abstract

We retrospectively examined the clinical characteristics, pathological features, and outcomes of BK viremia and nephropathy in a population of non-renal solid organ transplant patients (NRSOT) referred for outpatient nephrology consultation over a period of 5 years. In the entire cohort of liver, heart, and lung transplant recipients referred to this clinic, 14% percent were found to have BK viremia with a median peak serum BK viral load of 35 500 copies/ml (range 250 to 21 100 000 copies/ml). BK viremia resolved in six of the seventeen patients (35%). Four out of five patients biopsied showed BK virus (BKV) nephropathy. Eleven out of seventeen patients with BK viremia developed advanced (stage 4 or 5) chronic kidney disease. Four patients developed rejection of their solid organ transplant within the first year post detection of BK viremia after immunosuppression reduction. We conclude that a multi-center study is required to evaluate whether implementation of a systematic BK screening program would be effective in early detection and management of this problem in the NRSOT population.

Original languageEnglish (US)
Article numbere14265
JournalClinical Transplantation
Volume35
Issue number5
DOIs
StatePublished - May 2021

Keywords

  • BK virus
  • immunosuppression
  • renal failure
  • solid organ transplant

ASJC Scopus subject areas

  • Transplantation

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